The NHS in England is to offer more than 1 million people weight-loss drugs to reduce their risk of heart attacks and strokes.
Semaglutide (Wegovy) is already available on the health service for some people living with obesity, and also offered under the brand name Ozempic to treat type 2 diabetes.
Now people who are not obese but overweight and at risk of serious cardiovascular events will also be eligible for the weekly injections, after a watchdog gave the green light.
The National Institute for Health and Care Excellence (Nice) said people with a body mass index (BMI) score of 27 or above who have had a heart attack, stroke or serious circulation problem in their legs should be offered semaglutide to ward off life-threatening cardiovascular events.
NHS England said about 1.2 million people could benefit.
Semaglutide is best known as a weight-loss drug. But the Nice recommendation is specifically about preventing heart attacks and strokes
The weekly injections will be an extra treatment, offered on top of medicines people are already taking, such as statins, and alongside a reduced-calorie diet and increased physical activity for those at high risk of another serious event.
Clinical trials found semaglutide reduces the risk of a heart attack, stroke or cardiovascular death.
Crucially, this benefit was seen before significant weight loss occurred, suggesting the drug works directly on the heart and blood vessels, not just through weight loss, Nice said.
The Guardian reported last year how the largest study of its kind, led by University College London (UCL), found semaglutide cuts the risk of heart attack or stroke regardless of how many kilograms people lose.
The findings, published in the Lancet, suggested the drugs could have wider benefits for patients beyond weight loss, so should not be restricted to the most obese patients.
Previous analysis found semaglutide reduced the risk of major cardiac events by 20%. In October, researchers said they had now found the benefit was apparent regardless of how much weight people lost while taking the drug.
On Wednesday, Helen Knight, the director of medicines evaluation at Nice, said the evidence from the UCL study was “compelling”. It showed people taking semaglutide with existing heart medicines were “significantly less likely” to have another heart attack or stroke, she added.
“We know that people who have already had a heart attack or stroke are living with real fear that it could happen again. Today’s decision gives thousands of people in that situation an extra layer of protection, on top of the medicines they are already taking.
“Our role is to help practitioners get the best care to people while ensuring value for the taxpayer, and we are confident this rigorous, transparent recommendation strikes the right balance between clinical effectiveness and the best use of limited NHS resources.”
The Nice green light is draft guidance. But NHS England officials said the new group of people eligible for semaglutide would be able to access the drug “within months”.
Helen Williams, NHS England’s clinical director for cardiovascular disease prevention, said: “For more than a million people at high risk of heart attack and stroke, this treatment on the NHS could be life-changing – offering a powerful new way to protect their hearts and improve their health.
“We know that people who have already had a heart attack or stroke face a much higher risk of having another. Used alongside a healthy diet and regular exercise, semaglutide could help prevent thousands of future major cardiovascular events and give many people the chance at a longer and healthier life.”
Sharon Hodgson, the health minister, said weight-loss drugs were a “gamechanger” and giving them to people at risk of heart attacks and strokes would be a “lifesaver”.
Dr Sonya Babu-Narayan, the clinical director of the British Heart Foundation, said semaglutide had proven benefits “beyond reducing the number on the scales” and weight-loss drugs were now considered “important medicines” for preventing cardiovascular events.
Prof Naveed Sattar, professor of cardiometabolic medicine at the University of Glasgow, said: “This is very good news and stems directly from high-quality trial evidence.
“We now have medicines that not only reduce heart attacks, strokes and peripheral arterial disease but also simultaneously lead to meaningful weight loss – which in turn lowers the risk of many weight‑related conditions. These treatments also improve patients’ quality of life in a meaningful way, making this a genuine win–win.”
Riyaz Patel, professor of cardiology at UCL, welcomed the move but said there were questions over whether the NHS had the capacity to offer the drug to so many people.
“Overall, a really exciting development, for patients and doctors, giving us another powerful tool to reduce CVD [cardiovascular disease] risk.”
